Tubuslose superponierte Hochfrequenz-Jet-Ventilation (SHFJV) bei hochgradigen laryngealen Stenosen
| Autor: | Eva Schragl, A. Donner, M C Grasl, T. Kimla, Alexander Aloy |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Laser surgery
Larynx medicine.medical_specialty business.industry medicine.medical_treatment medicine.disease law.invention Surgery Stenosis medicine.anatomical_structure Otorhinolaryngology law Anesthesia Ventilation (architecture) medicine Arterial blood Airway business Laryngeal Stenosis Prospective cohort study |
| Zdroj: | Laryngo-Rhino-Otologie. 73:405-411 |
| ISSN: | 1438-8685 0935-8943 |
| DOI: | 10.1055/s-2007-997162 |
| Popis: | UNLABELLED Massive stenosis of the larynx may present a potentially life-threatening situation for the patient, requiring immediate measures to ensure a patient's airway. The aim of this prospective study was to evaluate potential benefits of Superimposed High Frequency Jet Ventilation (SHFJV) in patients requiring microlaryngeal surgery due to massive stenosis of the larynx. PATIENTS AND METHODS 23 patients (age range 1.5 to 90 years) with laryngeal stenosis grade 2 and 3 according to the Cotton scale were ventilated using SHFJV. The duration of the SHFJV was 12 to 116 minutes. SHFJV was performed using a Bronchotron Respirator via a jet-laryngoscope. RESULTS Arterial blood gases demonstrated paO2 between 71 and 295 mmHg and paCO2 of 28 to 81 mmHg. The mean FiO2 applied was 61.75 +/- 19.26. The airway pressure was measured at the tip of the jet-laryngoscope and was between 6 and 15 mmHg, and PEEP was 1 to 5 mmHg. In 13 patients a CO2 laser was utilised during surgery. DISCUSSION In all patients SHFJV was performed without problems. Since the ventilation is delivered above any possible stenosis the danger of barotrauma is minimised. The surgeon obtains optimal visibility of the larynx and is not obstructed in the surgical procedure. SHFJV enables both the surgeon and the anesthetist to perform their respective duties and therefore increases the safety of the patient in the management of such a difficult problem as massive stenosis of the larynx. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|